Typhoid fever and other systemic Salmonella infections are severe diseases responsible for more than a hundred thousand deaths each year. Poverty and inadequate hygiene facilitate massive outbreaks, lack of medical support results in severe courses of the disease leading to complications and death. Furthermore the general situation in the areas mainly affected means that the data collection is poor, neither the diagnoses nor the reporting system are trustworthy. Nevertheless even the rudimentary data available provide a serious basis for some conclusions. The Indian subcontinent is a proven high risk area for these infections. The emergence of (multi-)resistant strains has made efficacious treatment more difficult; most of the patients have no access to modern medicine. Whereas the number of reported cases of typhoid fever was rather stable in recent years, the number of S. paratyphi A infections has steadily increased and in some areas has reached the levels of typhoid fever. Vaccines with acceptable efficacy are available against typhoid fever (S. Typhi), only. Thus improvement of prophylaxis on the basis of food hygiene, drinking water quality and sanitation remains very important.
